AIDS bill is dilemma for Clinton
By Alexander Bolton
An AIDS funding bill that has stalled on the Senate floor has put Sen. Hillary Rodham Clinton (D-N.Y.) in a difficult position — forcing her to choose between the interests of her home state and those of battleground states in the 2008 presidential election.
Elected officials and AIDS activists from Iowa, South Carolina, and Ohio are urging senators to pass the Ryan White Comprehensive AIDS Resources Emergency Act, which would increase their state’s funding for people infected with HIV, the virus that causes AIDS.
A group of activists and officials are focusing their efforts on Clinton because she has the highest profile among the bill’s opponents. They may also be calculating that they have most leverage with her because she is expected to run for president.
Iowa and South Carolina will host two of the earliest contests of the 2008 Democratic presidential primary, and Ohio is expected to be a crucial battleground.
The bill, also known as the Ryan White Care Act, reauthorizes federal funding to fight AIDS. It would steer money away from major urban areas in New York, New Jersey and California to smaller, more rural states that have seen a dramatic increase in HIV infections in recent years.
The bill, which was originally passed in 1990, expires at the end of this week, the end of the 2006 fiscal year. Without a reauthorization, federal funding will continue at current levels.
Clinton and her New York colleague, Sen. Charles Schumer (D), outlined their objections to the new funding formula in a recent letter to Senate Minority Leader Harry Reid (D-N.Y.).
“New York State stands to lose more than $78 million in Ryan White Title II funds over four years,” they wrote. “Without modifications to address our concerns, we stand united on behalf of New Yorkers living with HIV/AIDS in objecting to this bill.”
Clinton and Schumer also wrote that the bill would reduces grants to Buffalo and Albany and could cost New York City as much as $17 million in lost federal funds next year. They stated that they support providing funds needed by other areas of the country, but not at the cost of established programs in their state.
That position puts Clinton at odds with Iowa Gov. Tom Vilsack (D), who urged for AIDS funding to be restructured in a letter to Sens. Mike Enzi (R-Wyo.), the chairman of the Senate health committee, and Edward Kennedy (Mass.), the panel’s ranking Democrat.
“Iowa is one of many rural states that receive no Title I funding at all,” Vilsack wrote. “[M]any states, including Iowa, have been forced to institute waiting lists for treatment or other cost-containment measures. This is unacceptable. The CARE Act should fully fund all 50 states’ [AIDS Drug Assistance Programs].”
If Vilsack does not run for president himself, he could help one of the Democratic presidential contenders gain an edge in the January 2008 Iowa Caucuses. Even if he does run, Vilsack would still be influential in the outcome of the contest.
Enzi attempted and failed to get agreement to bring up the bill on the Senate floor Tuesday and will try again, said an aide.
Three prominent Democratic public officials from Ohio, a state that narrowly decided the 2004 presidential race, have pressured Clinton recently.
Donald Plusquellic, mayor of Akron, Rhine McLin, mayor of Dayton, and Mark Mallory, mayor of Cincinnati, have each written letters to Clinton since mid-August urging her to support the revised formulas in the reauthorization bill.
“The current act disproportionately rewards larger cities at the expense of medium sized cities such as Cincinnati,” wrote Mallory. “This is especially important in states like Ohio with multiple urban centers. The reformed act would go a long way to address these funding deficiencies and greatly increase funding for many medium sized cities, including a potential increase of $79,000 to Cincinnati.”
McLin highlighted the effect on African Americans, a substantial Democratic constituency in Ohio as well as in South Carolina.
“Here in Ohio, African Americans were 45 percent of new AIDS cases in 2004, according to the Centers for Disease Control. Nationally, African Americans were 48 percent of new AIDS cases that year, while in some Southern states the percentage reaches as high as 75 percent,” wrote McLin.
Clinton is one of a small group of Democrats holding up the bill, said Craig Orfield, a spokesman for Enzi. He said that in addition to Clinton and Schumer, New Jersey Sens. Frank Lautenberg (D), Robert Menendez (D) and Sen. Barbara Boxer (D-Calif.) are thought to oppose the bill.
Dr. Kent Stock, an infectious disease physician from Charleston, South Carolina, who has helped lobby local state legislators on the economic costs of not stopping the spread of HIV, said Clinton has emerged as the most prominent opponent in the eyes of local AIDS activists.
“Hillary has taken a lot of heat because a lot of people are saying that it’s Hillary who’s putting her foot down on this act. In reality, it’s not just Hillary.
“She has become the figurehead. There are a lot of people saying that Hillary has the ability to move it forward or hold it up in Congress…She’s protecting her turf as any good senator would do.”
But Clinton’s position may require her to answer tough questions if she campaigns in the South Carolina next year or in early 2008.
“I think its going to hurt persons with HIV first and foremost where African Americans in my state represent 73 percent of the people affected,” said Dr. Bambi Gaddist, executive director of the South Carolina HIV/AIDS Council.
African Americans are estimated to make up a third or more of the Democratic electorate in the state.
State Rep. Joe Neal, an African-American Democrat from South Carolina, said about 300 people in his state diagnosed with HIV are on a waiting list to receive medical treatment. Passage of the Ryan White Care bill would eliminate the list, he said.
“The AIDS crisis is now shifting to the south fairly dramatically,” said Neal, who has advocated for more funds. “I understand that the political reality that the senator faces in protecting her own state and her interest but this is a larger interest than just New York and I hope she would think about it in that context.”
Clinton’s staff did not respond to several requests for comment.
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